Blue Cross Blue Shield Federal - Basic (Texas) (lap band to rny or sleeve)

[band2RNY 12]

Ok. I wonder if anyone has had this experience with FEPB.

I'm having lap band revision to sleeve or RNY. I call the insurance company on Wednesday of last week and the guy said I was approved. All excited... didn't rush into anything until the next day.

I get a call from my doctors office Friday saying that they need more documentation ( 3 month diet plan, psych eval, etc.) I never had to have all this when I had my lap band in 2010 so I was fuming because I already purchased airline tickets for family members to come down to Texas for surgery.

I called the insurance and they sent out two letters. One that is approving the procedure for lap band removal. The 2nd letter is coded for the sleeve/rny and it says before they can look at it need the 3 month diet, etc.

So, I call... and I told the lady what happened and she had referred it to the person that sent the letters out to look at it. She called me back and I explained to her basically you are approving one surgery and you are pretty much going to force me into doing two surgeries. She was so persistent on the documentation telling me over and over they need that. I asked her do you even look at the cost of two surgeries and does that justify me not having to do the 3 month, diet. etc. She said they do but that they still need the documentation?????

Has anyone gotten through this problem without having to jump through hoops?

[M.A. Cruz 15]

That sucks man. Honestly the best thing to do is give them what they need/want. Its a downhill battle when you fight with these insurance companies.

[band2RNY 12]

yeah, which i still have time to do but i'm hoping someone tells me something that I can use now or after all this is submitted just in case they try and pull something once everything is submitted...

I've thought about appealing it but i don't know....

[oldoneyoungagain 200]

Yes, I had to go through another three months hoop jumping before they would do bypass, even though they approved to have the band out. But somewhat happy it was done this way, because of the complications from scar tissue caused by the band. I'm sorry you had to go through this, I was informed prior to having my band out, so started jumping through the hoops so ended up only waiting ten weeks. Haven't had a single problem, yet. It will be 2 months the 11th since surgery. By the way I'm not under the Federal Program, but close, Medicare.